CrossFit Kids Emergency Card and Photo Release Form

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Emergency Card and Important Information

Parent/Guardian: ______________________________________________________________

Email: _______________________________________________________________________

Primary Phone: (_____)____________________ Other phone: (_____)____________________

What information do we need to know so that we may provide the best care for your children?

Additional Contact Info

The following additional people have my consent to pick up my child from CrossFit Glen Burnie

Name _____________________________________/cell phone: (____)__________________

Name _____________________________________/cellphone: (____)___________________

Name _____________________________________/cellphone: (____)___________________

Release to administer medication
Release to administer medication (please specify) and/or rescue inhaler


Approving Signature

Signature: __________________________________________ Date: _____________________

Photo Release Form
I hereby give permission for images of my child, captured during regular and special activities, through video, camera and digital camera, to be used solely for the purposes of CrossFit, CrossFit Kids or Licensed CrossFit affiliate promotional material publications and website and waive any rights of compensation or ownership there to. Last names of minors will not be given or posted on the internet or website.

Consent and Release Agreement
I hereby give permission for my child to participate in the Kids CrossFit classes and youth program activities conducted at our training facility. I am aware that there are significant risks involved in all aspects of physical training. I willingly assume full responsibility for the risks that I am exposing my child to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of CrossFit Glen Burnie.

I acknowledge that my child I have no physical impairments, injuries, or illnesses that will endanger me or others.

In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by CrossFit Glen Burnie, I, the undersigned hereby release CrossFit Glen Burnie, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect.

I also give full permission for any person connected with CrossFit Glen Burnie to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the wellbeing of the child.
The participant recognizes that there is risk involved in the types of activities offered by CrossFit Glen Burnie. Therefore I accept financial responsibility for any injury that the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless CrossFit Glen Burnie, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by CrossFit Glen Burnie. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building, and/or any area selected for training by CrossFit Glen Burnie.


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Download our CrossFit Kids Information Packet